307 Total test at age 31. (Infertility, will HCG help?)

[TheJailer521]

Well long story short, had a vericocele that I had treated 8 months ago which I had hoped would cure our fertility issues. It raised my sperm count but not enough.

Before spending the $ on IVF, I decided to get my labs done again here are the results:

TESTOSTERONE: 307 ng/dL Range: 220 - 800 ng/dL, which is DOWN from 405 when taken 3 years ago.
LH: 4.2 mIU/mL Range:1.7 - 8.6 mIU/mL
FSH: 11.5 mIU/mL Range: 1.5 - 12.4 mIU/mL
PROLACTIN 9.8 ng/mL Range: 2.2 - 14 ng/mL


I have read running HCG after vericocele can "jump start" the system a bit. Is that worth a try?

Thank you for any and all information.

 

[619sss]

Clomid and nolvadex better

 

[GreekTheBrick]

Have you done a sperm diagram as well? Only blood tests arent safe method to determine fertility.

I believe hCG is better for increasing sperm count whereas clomid for raising test(sure it increases sperm as well).

Whats your doctor's opinion?

 

[TheJailer521]

Did the sperm test they recommend ivf with ICSI. I explained to him that I had the surgery done in November and he agreed my count can rise for up to a year.

Now I'm doing all I can to fix what I can before shelling out 10-15k on ivf.

My Dr reordered my full hormone labs this morning to see if my 307 was a fluke.

 

[Todd Garner]

I would keep checking the sperm count FSH is on the higher end which shows your boys are trying their best to make sperm. Keep checking your count and make sure you diet and stress levels are good, also wouldn't hurt to do a Heavy metal toxicity test.

 

[bad rad]

hCG injections have been used to treat infertility in men but the sides can suck. Clomid has issues as well at the commonly prescribed dosage but tends to be very tolerable at 12.5mg 3-4 days a week. It was developed to induce ovulation but causes men to produce more sperm.

 

[GreekTheBrick]

This is a very sensitive issue and since you are coming off a surgery makes it even harder to give any advice. You dont want to do something and end up having no sperm at all.

Your approach should be "less is better"(either low dose of clomid or low dose of hCG). You may also need to control e2 with an AI, but "less is better" applies here too, as very low (or very high e2) will negatively affect sperm count and strength. Recently learnt that intratesticular estrogen(usually raised by hCG), cant be controlled with an AI, so its something to consider.

Not much help I know. There are people with more knowledge in here, hope they will join the topic

 

[TheJailer521]

I had tracers while using clomid, in the past (Years back for pct) so the vision symptoms worry me with using that. Thisis the article that got me interestedin HCG after vericocele surgery:

Human chorionic gonadotropin adjuvant therapy for patients with Leydig cell dysfunction after varicocelectomy.

Abstract
The authors treated 135 men who underwent varicocelectomy, but had sustained Leydig cell dysfunction disclosed by LHRH test with human chorionic gonadotropin (hCG). hCG was administered for 10 weeks: 50,000 units were given in 10 divided doses intramuscularly. Semen analysis and measurement of serum hormone level were obtained 8 weeks after the completion of treatment, and every 3 months after that. All patients were followed up for 2 years to confirm pregnancy. Fifty-five percent of patients achieved pregnancy and they showed significant increase in sperm density, percentage of sperm motility, normal form sperm, and serum testosterone level. It is recommended that hCG be administered to patients who undergo varicocelectomy but have persistent subtle Leydig cell dysfunction disclosed by LHRH test to stimulate the intratesticular testosterone production.


------------

I got 2 of my new labs back already:

LH is down even further from Mondays reading of 4.2.
LH 2.5 mIU/mL Range: 1.7 - 8.6 mIU/mL

And FSH stayed basically the same:
FSH 11.4 mIU/mL Range: 1.5 - 12.4 mIU/mL

I will continue to update as the labs come in.

 

[GreekTheBrick]

I get email notifications for this topic but I dont see any new posts

 

[sammpedd88]

I get email notifications for this topic but I dont see any new posts

I did too man

 

[TheJailer521]

Labs in from Friday:

TOTAL TESTOSTERONE 276 ng/dL Range: 250 - 1100 ng/dL
FREE TESTOSTERONE 45.6 pg/mL Range: 35.0 - 155.0 pg/mL
PROLACTIN 8.6 ng/mL Range: 2.2 - 14 ng/mL

 

[GreekTheBrick]

What are you planning to do mate?

 

[TheJailer521]

@ 307 Dr told me it was still in the "Low Normal" range for my age, which I disagree with. Now that he reordered it and it came back at 276 hopefully that prompts him to do something, even though the "Low threshold" at my Dr's office is 250.

I wrote him my concerns and that I would like to give hCG a go to see if I cant restart my system. If he doesn't agree, or come up with an alternative plan I will contact on online trt clinic and see about geting hCG through them.

If that fails to raise my test and sperm count then I will go through with the IVF, and once my wife is pregnant I will start TRT.

 

[GreekTheBrick]

That sounds good planning. Hope for the best OP

PS. Thats so stupid by your doc to must have 250 or below test in order to take action. Like people are just numbers, not unique entities that need to be treated individually. So stupid approach.

 

[TheJailer521]

Much appreciated. Ill update if/when he gets back to me.

 

[bad rad]

Clomid typically has worse sides than hCG.

Reread my post. I didn't say it was side effects free. Much like hCG it tends to get overdosed for our needs since they differ from the original treatments. Clomid at 12.5mg 3x weekly has very low sides for most and tends to have similar effects to 50mg daily for our HRT needs.

 

[bad rad]

@ 307 Dr told me it was still in the "Low Normal" range for my age, which I disagree with. Now that he reordered it and it came back at 276 hopefully that prompts him to do something, even though the "Low threshold" at my Dr's office is 250.

I wrote him my concerns and that I would like to give hCG a go to see if I cant restart my system. If he doesn't agree, or come up with an alternative plan I will contact on online trt clinic and see about geting hCG through them.

If that fails to raise my test and sperm count then I will go through with the IVF, and once my wife is pregnant I will start TRT.

If you can start hCG and become fertile you may be able to start TRT simultaneously. Combined therapy has shown to maintain fertility alongside TRT dosing at 500iu EOD.

 

[bighulksmash]

We "me and wife" had this problem 8 yrs ago . Although my test was high sperm were great she had pcos . We were able to conceive and had a boy after countless treatment.

Now we want another child , sperm count is still high but now morphology and motility is low . I too considered a mixture of testosterone hcg or hcg and Clomid .

Definitely interested in your results.

Good luck !

 

[Todd Garner]

About to come off TRT and do a round of clomid and HCG myself while my wife and I try. My low T seemed to be a primary shut down when I went on TRT but hoping life style changes and heavy metal detox has helped that.

 

[bighulksmash]

About to come off TRT and do a round of clomid and HCG myself while my wife and I try. My low T seemed to be a primary shut down when I went on TRT but hoping life style changes and heavy metal detox has helped that.

What's the heavy metal detox?

 

[Todd Garner]

TRT Doc had me do a heavy metal toxicity test, my levels were off the charts, been taking heavy metal detox supps for a few weeks now.

 

[bighulksmash]

TRT Doc had me do a heavy metal toxicity test, my levels were off the charts, been taking heavy metal detox supps for a few weeks now.

Ok i never thought of checking that out .

 

[Todd Garner]

Ok i never thought of checking that out .

My Doc said its very over looked, can affect Test levels, bp, joints all sorts of things.

 

[GreekTheBrick]

TRT Doc had me do a heavy metal toxicity test, my levels were off the charts, been taking heavy metal detox supps for a few weeks now.

Can you name a few supps please?

 

[Todd Garner]

Can you name a few supps please?

EDTA, Chlorella are two that I am taking.

 

[GreekTheBrick]

Thanks man

 

[TheJailer521]

From my Dr:

"You have been doing your homework. The HCG study looked promising. I have asked Dr.*** for his opinion as well. I have not given HCG before. Testosterone may also be a possibility. If you do not hear back from me by Wed send me another email. "

Thank god I have a Doc who listens.

 

[DonnieM]

Any updates?

 

[TheJailer521]

My Dr and Urologist got scared of the hCG idea (they have never used that method.) They did give me a referral to the endocrinologist which I will keep on hand, but I chose to goto Defy. My bloodwork is done and I have my consultation on Sept 6th. I'm excited, the days aren't going fast enough though. Will continue to update.

 

[TheJailer521]

I called Defy today to see if they had any appointments sooner, and I got to speak with the Dr 45 minutes later (due to a cancellation!)

Since fertility is my biggest concern, they are going to start me on Clomid/anastrozole/dhea and asses after 5 weeks. And due to my Hashimotos they are going to run a full thyroid panel, and recommended a sleep study due to my snoring (which can all effect testosterone.)

They are looking at every angle, something my Primary care and Urologists never took into consideration.

Very happy with Defy so far.

 

[GreekTheBrick]

It seems to me that they know their job

 

[TheJailer521]

So with the goal of improving fertility and raising test levels, I was prescribed clomid with great results.
I was really happy with the results, but had to stop due to visual symptoms. I have my follow up with Dr. Saya next month, looking forward to our next step.

The first # was pre-clomid, the 2nd was 25 days into taking it. 25mg day, along with 25mg DHEA, and arimidex 2x a week.

Total test: 430 to 885 (Range 250-1100)
Free test: 74 to 155.1 (Range: 35-155.0) H
Estoridal: 43 to 34 (Range: 8-43)
Dhea: 191 to 265 (Range: 160 - 449)
FSH: 11.4 to 20.8 (Range: 1.5-12.4) H
LH: 5.2 to 9.4 (Range: 1.7 - 8.6) H